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Oversupply, reflux and bobbing

FTM!

My son is 6 weeks old, at four days he was readmitted into the hospital for reflux that was causing him to aspirate and turn blue. He was tongue tied at birth and we had some issues with him nursing from the very beginning. He had a feeding tube and I was pumping for four weeks and he just recently had the tube removed a week ago. His latch was very painful so I saw a LC which helped a lot, but now I am having oversupply issues due to the pumping for a month. The LC has suggested block feedings, which I have been doing for a few days now. His stool is still mucusy and more of a golden yellow instead of the yellow mustard it was. I have been trying to hand express a little before feeding him so he can get to the hind milk, but I haven't done it for all feedings, should I? I don't want to express too much because I'm trying to get my body to produce less and that seems counterproductive?

I have also noticed that he just started bobbing on and off the breast toward the end of his feeding. I thought maybe this was gas so I have been trying to burp him as often as I can during nursing, but he hates that and screams wanting the breast but bobbing again. His he frustrated with the milk?

I just don't know what is wrong or what I can do. I hate to see him frustrated/uncomfortable. Any advice would be great!! TIA!!

Re: Oversupply, reflux and bobbing

wow you have had some scary times with baby and a really difficult start to nursing-great job sticking with it-comparatively, all going pretty well now though?

'bobbing'-do you mean bobbing that is similar to what a baby normally does when they want to nurse-as in, baby is bobbing head on dad's chest or grandmas chest so they hand baby to mom..., or, during a feeding, when mom takes baby off or baby pops off on thier own, realize they want to nurse some more, so they start bobbing on mom-if so, this is simply normal rooting behavior...and it can appear quite frantic, especially if baby has a fussy 'time'...
or do you mean, pulling on and off the nipple, as in frustration, during feedings? this could be a reaction to a fast flow (forceful letdown) or again, baby is just fussy and, like fussy kids of all ages, is not sure what he wants- or, baby needs to burp.

What are the symptoms of oversupply you are experiencing? While oversupply and forceful letdown can cause nursing issues and possibly gastointestinal distress, trying to manage babies intake so the get more 'hindmilk' is probably unnecesary-all your milk is good for baby, and the milk transitions gradually throughout the feeding-hand expressing a little prior to nursing is one technique for helping with forceful letdown issues, but its primary purpose is to make the flow slower for a baby who objects to a fast flow.

Besides block feeding, which may or may not be needed depending on the severity of the oversupply, have you tried other, more immediate results oriented ideas for helping baby handle a fast flow-nursing very frequently, nursing one side at a time, nursing 'uphill' (mom in a laid back position) taking baby off during initial letdown? have you seen this article? http://kellymom.com/bf/got-milk/supp.../fast-letdown/

Re: Oversupply, reflux and bobbing

Wow, congratulations on getting your baby to the breast after a rough start! Awesome job, mama!

I think that you are correct that expressing before nursing the baby is counterproductive, because it's just going to perpetuate the oversupply. Don't worry about the hindmilk. There's really no such thing as hindmilk and foremilk- just milk. It's relatively rich in water and carbohydrates and lower in fat at the beginning of a feeding, and gradually becomes increasingly creamy as the breast empties- but even if a baby got nothing but "foremilk" it would be okay, because that lower-fat milk still has everything a baby needs to grow and develop. It's quantity of milk that matters, not quality, when it comes to growth.

Bobbing at the breast- I presume you mean latching and unlatching several times in succession? That's pretty normal towards the end of a feeding. Baby may want a faster flow of milk as the breast empties out, or he may want a slower flow and be frustrated that the breast continues to deliver a rapid flow. Or he could just be tired. Anyway, it's not a big deal and it's something that will disappear as your LO gets older and becomes a better nurser.

ETA: LLLMeg beat ne to it, and she has a brand-new baby! Now I feel like a slouch.

Re: Oversupply, reflux and bobbing

The bobbing is not routing its more of the latch on and off, so its good to hear that this is normal and will subside at some point.

As for the oversupply symptoms. He has been spitting up a lot, so much that it was starting to make me wonder if he was getting enough food, which is he because he gained 12 ounces in a week (another concern I had that this was too much). When he latches on it seems like he's gulping a lot and trying to coordinate breathing and drinking. He doesn't cough or seem to be choking on the milk but he also doesn't seem to be having an easy time with the flow and/or amount. He also doesn't seem to know when enough is enough? Maybe that's why he spits up so much? Sometimes he spits up during nursing and it gets everywhere. The spit up is normally runny with a little thick saliva or even mucus in it.

The LC did say that it sounded like I had a forceful letdown and suggested laid-back or even "Australian" hold to help him with the flow a little. I have been trying both and the laid-back seems to be helping but as of last night he has started some of his old habits of biting down and rubbing his tongue on the nipple causing irritating.

Is it possible that I'm just trying too hard to make this work out 'perfectly'? I hate to say it but I'm just getting frustrated, seems like everyday there is something different thats not going right.

Re: Oversupply, reflux and bobbing

Rapid weight gain + frequent spitting + gulping and difficulty coordinating nursing and breathing = many of the symptoms of forceful letdown. Keep rockin' those reclined positions, stay away from the pump, and don't worry about the spitting. If a baby spits without evidence of discomfort, it's a laundry issue, not a health issue.

I totally understand how a mom can drive herself crazy trying to make everything work out perfectly. I think it's a huge challenge for nursing moms to relieve themselves of some of the responsibility for the things their babies do or don't do. I can't tell you how many times we see moms here saying "My baby is fussy, it has to be something I ate- but what??!" or "My baby isn't sleeping, is my supply too low?" or "My baby had this one weird-looking poop, so how do I eliminate all allergens from my milk?". of course the response is almost always "Relax, your baby is being a baby and he's going to have fussy days and sleepless nights and weird-looking poops- and it's not your fault."